HomeMy WebLinkAboutAG EXPRESS LLC - INSURANCE CERTIFICATE (2)AC-0-RD. CERTIFICATE OF LIABILITY INSURANCE
PRODUCER (970) 834-1337
CROSSROADS IN THIS CERTIFICATE IS IS
INSURANCE AGENCY NO FAX; (970) 834-1393 ONLY AND CONFERS NO
119 2NL) AVENUE HOLDER.
RHE CIS CERTIFICATEP.O. BOX 1010
ALTER ERAGE AFFO
'CULT CO 80610-1010
INSURED INSURERS AFFORDING COVERAI
AG EXP SSLI, INSURER A: NORTHLAND INSURE
C FAX: (970) 416-9436
BRIM XRAL'T INSURER B:
5532 NORTH COUNTY ROAD 9 INSURER C,.
FORT COLLINS CO 80524- IN URER D'
INSURER E:
COVERAGES
THE POLICIES
A
I
AIMS MADE
EGATE LIMaIIT
JER&E LIABILITY
TOED AUTOS
LEDAUTOS
UTOSNED AUTOS
ANY
WN01597B
NN075904
WN015978
WNO75984
NYAUTO
N/A
BSNMBRELLA LIABAIry
N/A
OCCUR ❑CLAINBMADE
EDUCTIBLEETENTION
4OMPENSA7IUNANDN/A
AD�RRCMARG
' LIAEjU'IETO"MTNE
WEXECUTIVE
MBER EXCLUDED?
VIS 0 S lwpGO
hR7015978
RN0759B4
lnw m t!J ABOVE FOR THE POLI
OR oTFIER DOCUMENT WITH RESPECT TO WHICH THIS
BED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLI
Y PAID CLAIMS.
.ICY NUMBER PDLICy EFFECTIVE POLICYEJ(%RADp
DATE MMA)ONV DATE MMAIDA'Y
08/10/2010 08/10/201,
.___.__........,.. �,�•cwu�w91ON8 AODBD BY END01
TRUCKERS
CERTIFICATE HOLDER IS LISTED AS AN ADDITIONAL IRSIJRED
CITY OF FORT COLLINS
215 NORTH MASON
P.O. BOX S80
FORT COLLINS
CORD 25 (2001l08)
15025 (01w),%
TO 39dd
Y}v
30NvanSNI SaVOJSSONO
00/10/2011I 08/10/2012
DATE(MMIDDfIYYY)
UPON
NOT A
BE ISSUED OR MAY PER
)ITIONS OF SUCH POLI
LIMITS
E 3 1,000
1
�� COMBINED SINGLE LIMIT
(Ea ACCIAEnt) g 11000,
D8/10/2011 08/10/2012 BODILY INJuRv
(Pw PM ) i
BODILY INJURY
(Pw aaMmt) g
PROPERTY DAMAGE
(Pv xciam) i
AUTO ONLY -EA ACCIDENT S
OTHER THAN EA ACC S
AUTO ONLY:
p1L� E
/ / TOF IMRS ER
El. EACH ACCIDENT g
/ / E.L DISEASE - EA EMPLOYE S
E.L, DISEASE - POLICY LIMIT S
OB/SO/2010 OB/10/2011 10,000
08/10/2011 08/10/2012 DTDUCTXBLE 250
CANCELLATION
SHOULD ANY OF ABOVE CESCRIBED POUOMS BE CANCELLED BEFORE TIIE
EXPIRATION D THEREOF, THE ISSUING INSURER VALL ENDEAVOR TO MAIL
3O lA N NOTICE TO E CERTIFICATE HOLDER NAMED TO THE LEFT, BUT
FgILU DO 90 BNALL IMPOE N° OBWOATION OR UABIUIY OF ANY AND UPON THE
X 0 ACORD CORPORATION 191
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